Native Americans are 2-4 times likely to have hearing loss compared to white, African American, or Asian Americans. Hearing impairment has great cultural significance to Native Americans due to the reliance on oral communication and the transmission of knowledge held by elders. Noise-induced hearing loss (NIHL) and related tinnitus are significant health risks for the general population and Native Americans are likely to be at-risk because of ways of life and situational noise exposures. A partnership including the Northwest Portland Area Indian Health Board and Oregon Health & Science University scientists will identify health communication strategies that are culturally acceptable, feasible, and sustainable for Native American communities and that will ultimately reduce the incidence of noise-induced hearing loss and related tinnitus. The target populations are 4th, 7lh and 10lh grade students, tribal school teachers, adults exposed to occupational noise, and adults from the general population, from two Northwest tribes. Four interventions will be evaluated by these tribal representatives: 1. The Dangerous Decibels Z museum exhibition at the Oregon Museum of Science and Industry, 2. A web-based Virtual Exhibit of activities, simulations and NIHL prevention information, 3. An interactive, inquiry-based classroom presentation on NIHL prevention, and 4. An automated system that educates, tests hearing function and provides tailored feedback on risk behaviors. While these modalities differ in their effectiveness, each provides a complementary means of delivery of prevention information, and has its own strengths and limitations. We hypothesize that these modalities will be accepted by tribal people, and are generally suitable with cultural adaptation. Questionnaires will be used to assess reactions to the communication process of each intervention, as opposed to measuring shifts in knowledge, attitudes, and beliefs. Focus groups will assess social and cultural issues of the interventions that may or may not need adapting for tribal settings. The findings will be analyzed by tribal community members and OHSU investigators and presented to the tribal communities. The partners will use the results to develop a strategy for future, community-based NIHL prevention research using modified or possibly new interventions with the goals of behavioral changes regarding hazardous noise exposures and to reduce the incidence of preventable noise-induced hearing loss and tinnitus. [unreadable] [unreadable] [unreadable]